2024 Member Info and Committee Sign-Up

2024 Member Info and Committee Sign-up Form

Soror, this is a 3-part form. It should take approximately 8 minutes to complete. One goal for this form is to gather all of your CURRENT information to put in our chapter directory. Another goal is to know your skills and talents. Part 1 relates to your basic information; Part 2 relates to your occupation, skills, and hobbies; Part 3 asks about the committee(s) you would like to serve on. If you want to save this form and return later to finish it, you must create a FREE Jotform account.
SECTION 1: MEMBER INFORMATION
Please complete all information below:
Name*

First NameLast Name
Name as Printed in the Directory*
E-mail*
Cell Phone*
Format: (000) 000-0000.
Home Phone
Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Birth Month*
Birth Day*
Birth Year
YesNo
YESNO
Chapter of Initiation*
If undergrad chapter, please list the name of the college/university.
Month of Initiation*
Year of Initiation*
Emergency Contact #1 (Name)

First NameLast Name
Emergency Contact #1 (Phone)
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact #2 (Name)

First NameLast Name
Emergency Contact #2 (Phone)
Please enter a valid phone number.Format: (000) 000-0000.
Please list any allergies you have.
Please share with us your medical history that may be pertinent in the event of an emergency.
Please list any medications you are taking.

2024 Member Info and Committee Sign-up Form